Nasal T/NK cell lymphoma: report of 3 cases involving the palate.
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Malignant lymphomas that originate in the nasal cavity, paranasal sinuses, and hard palate form an interesting and diagnostically challenging group. In the past, many of these cases have been included in the clinical spectrum of the so-called lethal midline granuloma syndrome. This unusual condition is characterized by progressive erosion of the nose and paranasal sinuses, accompanied by destruction of soft tissues, cartilage, and bone. There are a variety of causes for such nonhealing midline granulomas, including multiple inflammatory and infective agents, collagen vascular diseases, malignant lymphoma, carcinoma, and disorders of unknown origin. The lymphomas associated with this condition are perplexing and difficult to manage. The situation is further obscured by the plethora of terms describing these lesions in the literature. However, recent advances in immunophenotyping and molecular genetics have brought significant progress in the understanding of these lesions. Most of these lesions are proved to be malignant lymphomas of the sinonasal tract. They can be of B-cell or T-cell lineage and have a broad biologic spectrum from low to high grade. The terms midline granuloma syndrome, lethal midline granuloma, polymorphic reticulosis, lymphomatoid granulomatosis, midline destructive granuloma, and idiopathic midline destructive disease are now considered obsolete. In this study, 3 cases of T/NK (natural killer) cell lymphoma involving the oral-paranasal region are described. They illustrate the typical clinical behavior, pathologic features, and the integrated approach to diagnosis of this rare condition.
Journal of Oral and Maxillofacial Surgery